Scientists from the University of Washington School of Medicine are the winners of the Gizmodo Science Fair 2023 for their experimental breast cancer vaccine.
The question
Can you train the immune system to target cancers that are about to come back or even prevent them from forming?
The results
The team’s vaccine should work by causing the body to mount a specific type of immune response to the HER2 protein, a protein naturally present in many cells but overproduced by around 30% of breast cancers. The theory is that this response, known as the cytotoxic (cell killing) response, will target these cancers but not harm the body otherwise.
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In November, researchers published data from a phase I safety trial of their vaccine, which involved 66 women with advanced breast cancer. The women had undergone treatment that put their cancer into complete remission or largely contained it, but they remained at high risk of it coming back aggressively. The volunteers were followed for a median of approximately 10 years.
During the trial, the vaccine showed no signs of serious long-term health risks, with the most common side effects being acute, short-lived symptoms like redness at the injection site and fever. The volunteers also developed the immune responses the researchers hoped the vaccine would generate. And although phase I trials are not intended to prove that a treatment works, only that it is safe, there was one clearly encouraging indicator of its effectiveness. About 80% of vaccinated women were still alive after 10 years, well above the five-year survival rate of 50% typically seen in people with similar cancers.
why they did it
“We aim to cure cancer, one vaccine at a time. And I know it might sound a little flippant to say this, but so much has happened in the world of immunology, and in the world of vaccines, and in the world of cancer (in recent years)” , said Nora Disis, project manager. Principal Investigator and Director of Cancer Vaccine Institute at the University of Washington. “I think we’ve reached a tipping point for cancer vaccines.”
Why their breast cancer vaccine is a winner
As Disis notes, there have been major successes of late in the area of what is called immunotherapy—medicines intended to strengthen the defenses of the immune system against cancer. There are now approved drugs that suppress checkpoints that prevent immune cells from targeting certain tumors, for example, as well as treatments that genetically transform T cells into potent cancer killers. There are several therapeutic vaccines against cancer already approved, but these have only shown modest efficacy against very specific types of cancer. Vaccines currently in development are expected to be generally more effective and able to treat a variety of cancers. And they could not only target resistant tumors that are likely to come back, but even those that have yet to emerge. Another promising approach is the use of these vaccines in combination with other immunotherapies.
The HER2 vaccine developed by Disis and his colleagues is far from the only one being studied at the UW Cancer Vaccine Institute, but it is the most advanced in clinical trials. And in many ways, it is the culmination of 30 years of work by Disis in particular.
“I think the first challenge, years ago, was just that people didn’t think the immune system played a role in eradicating cancer,” she said. “But now, really, the biggest challenge isn’t creating the vaccine or making the vaccine, it’s being able to find patients to enroll in clinical trials.”
Studies have find that as few as 5% or less of cancer patients enroll in clinical trials in general, not just those testing new vaccines.
“One of the other areas we’re working on is trying to increase the diversity of patients represented in clinical trials — making efforts to reach different parts of our community,” said Kiran Dhillon, executive director of the ‘UW Cancer Vaccine. Institute.
And after
The team is already leads Phase II trials of the HER2 vaccine and two other breast cancer candidates. They have also developed experimental vaccines against ovarian, colon, lung, bladder and prostate cancers.
Speaking of the field more broadly, Disis predicts that a therapeutic cancer vaccine will reach the public within the next five years.
The team
“Oh, we’re talking hundreds,” Disis said when asked how many people it took to get this vaccine off the ground. “Often people think of scientists as one person in some type of lab working until the wee hours of the night. But even in the group I work in, it’s like 40 people working until the wee hours of the night. And each person has a unique role to play in vaccine development. It’s not like there’s a leader telling everyone what to do.
“Another unique feature of our institute, which makes it a bit different from other academic labs, is that we do discovery, translation, and clinical trials under one roof,” Dhillon said. “So you’re not waiting for a collaborator to catch up with you for the next phase of the project. Everyone here is at the table.
See the full list of Gizmodo Science Fair winners